Term
An older adult was just diagnosed with stage 4 pancreatic cancer. The client states, "I am so overwhelmed and I feel like everyone has already decided that I need to be put in hospice care."
Complete the following sentence by choosing from the lists of options.
The nurse upholds the principle of autonomy by |
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Definition
offering to answer questions the client may have about care and treatment options
providing the client with the information needed to obtain a second opinion
The principle of autonomy upholds the client's right to self-determination; that is, respecting the client's right to make informed decisions about their care. Offering to answer questions pertaining to the client's care options provides the client with the opportunity to make informed decisions. Autonomy is one of the six foundational principles of ethical practice and refers to a competent person’s right to make their own choices without intimidation or influence. The nurse can provide the client with the additional provider options because it is the client’s right to seek a second opinion.
Providing emotional support and administering antipyretics for fever are acts of goodness; thus, they uphold the principle of beneficence. Obtainig routine vital signs is a part of the nurse's responsibilty. It is a means of fulfilling one's commitment to the client; therefore, it fosters the principle of fidelity. The principle of confidentilaity is upheld when the nurse shares pertinent information only to those directly assigned to care for the client. |
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Term
| A charge nurse has implemented staff education on nursing values. The nurse would determine that further education is required when which statement(s) are overheard? Select all that apply. |
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Definition
“I can’t believe the client is giving that precious infant up for adoption.”
“The gonorrhea test was positive. That’s what the client gets for sleeping around.”
“If that was my mother, I sure wouldn’t agree to a no-code.” |
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Term
| A parent teaches a child not to drink and drive; however, the parent does drink and drive. This action results in: |
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Definition
| a failure to model one's own values. |
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Term
| A nurse’s friend states, “I admire you so much. I would love to be a nurse, but I don’t think I have the courage.” Which response will the nurse make? |
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Definition
“You can work on being more courageous as you learn to be a nurse.”
Courage is a virtue of nurses that can be learned or strengthened with work. Courage is a quality nurses should possess. Courage is not less important than being intelligent, compassionate, or humble. |
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Term
| A nurse obtains an order for a bed alarm for a confused client. This is an example of which ethical principle? |
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Definition
Paternalism
Making a decision for a client who is confused to prevent an injury is an example of paternalism. Deception occurs when the true nature or reason is concealed and the client is deprived of basic human rights. Confidentiality requires a health care provider to keep a client’s personal health information private unless consent to release the information is provided by the client. Conflict is a disagreement or argument and does not represent the example in this question. |
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Term
| A nurse is providing care to an older adult client who was just diagnosed with cancer. The client together with the immediate family discuss their preferences with the health care providers involved. The health care providers offer their clinical recommendations about possible treatments. Ultimately, the group arrives at a decision. The nurse interprets this decision-making process as reflecting which type? |
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Definition
Shared
There are three basic models of healthcare decision making. In the paternalistic model, clinicians decide what ought to be done to benefit the client, inform the client, and the client's role is to comply. In the client sovereignty model, clients or their surrogates, expressing their right to be autonomous, tell the clinician what they want, and the clinician's role is to comply. Most ethicists reject these models in their extremes and recommend a model of shared decision making, which respects and uses the preferences of the client and the expertise/judgment of the clinician. Clinical decision making is the process that results from the use of a healthcare decision-making model. |
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Term
| A client tells the nurse that the client does not want to have a painful procedure. By respecting and supporting the client's right to make decisions, the nurse is demonstrating: |
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Definition
advocacy.
Advocacy is the protection and support of another person's rights. Nurses have always been strong client advocates, carefully evaluating the competing claims of the client's autonomy (self-determination) and well-being. Altruism is the principle and moral practice of concern for happiness of other human beings, resulting in a quality of life both material and spiritual. Justice is concerned with moral rightness and fairness. Confidentiality is keeping or one's personal information secret or private. |
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Term
| Which action would cause a charge nurse to have concerns about a nurse’s moral agency? |
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Definition
| The nurse was seen at a grocery store after calling in sick. |
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Term
| Which example most accurately depicts the ethical principle of autonomy? |
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Definition
Describing a surgery to a client before the consent is signed
Autonomy is the capacity to make an informed, uncoerced decision. Describing a surgery to a client before a consent is signed provides the client with all of the information needed to make an informed decision and thus an autonomous one. The nurse changing a dressing on a wound does not require the client to make an informed decision, nor does administering a morning dose of insulin or transporting a client. |
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Term
| Which example best describes feminist ethics? |
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Definition
An approach critiquing existing patterns of oppression and domination in society
Feminist ethics offer an approach critiquing existing patterns of oppression and domination in society, especially as they affect women and the poor. The principle-based approach to ethics combines elements of utilitarian and deontologic theories and offers specific action guidelines for practice. The care-based approach directs attention to the specific situation of individual clients viewed within the context of their life narratives. The formal study of ethical issues that arise in the practice of nursing describes nursing ethics. |
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Term
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Definition
cultivated dispositions of character and conduct that motivate and enable us to be good human beings.
Virtues are human excellences, or cultivated dispositions of character and conduct that motivate and enable us to be good human beings. Values are beliefs about the worth of something, about what matters, that act as a standard to guide one’s behavior. Morals are personal or communal standards of right and wrong. Ethical principles are general guides to action, including autonomy, nonmaleficence, beneficence, justice, and fidelity. |
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Term
| A nurse is administering evening medications and notices that a medication was omitted during the day shift. Which statement demonstrates the principle of accountability? |
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Definition
Filling out an occurrence report and notifying the healthcare provider
Accountability means that when an error occurs, the nurse takes the proper actions to address it. In this instance, the nurse should fill out an occurrence form for follow-up and notify the provider, as the error may change outcomes in the client's condition. Administering the missed medications with the other evening medications may double up the dose or cause unexpected adverse effects with the other medications. Telling the client that the medication will be administered the following day is not acceptable, as the nurse is suggesting next actions without the provider's knowledge. Documenting in the chart in a narrative about the occurrence does not allow for the health care provider to be notified and aware of a change in the client's condition. |
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Term
| A nurse is providing care to a client and is preparing the client for breakfast. The nurse assists the client out of bed to the chair and then helps the client open the items on the breakfast tray. The client begins to eat breakfast. The nurse tells the client, "I'll be back in about 10 minutes to check on you. In the meantime, here is your call light in case you need me." About 10 minutes later, the nurse returns to check on the client. The nurse is demonstrating which ethical principle? |
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Definition
Fidelity
Fidelity involves keeping promises and being faithful to the promises made. In this case, the nurse tells the client that she will return in 10 minutes and then follows through with the promise. Nonmaleficence involves doing no harm and avoiding actions that deliberately harm a person. Autonomy refers to the right to make one's own decisions. Justice involves treating each person fairly and without judgment. |
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Term
| What would be an example of the nurse practicing fidelity? The nurse: |
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Definition
stays with a client during death as promised.
Fidelity requires the nurse to keep promises made and to be faithful to one's commitments. Regulating visitors is a demonstration of the value of privacy. Withholding client's information as requested is an example of maintaining confidentiality. Providing continuity of care is an example of integrity and professionalism. |
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Term
| The nurse is attempting to clarify the values of an adolescent client. The nurse should identify what factor as having the greatest influence on an adolescent's value formation during this developmental stage? |
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Definition
Peers
In adolescence, peer groups have a major influence on value formation. The attitudes, beliefs, and behaviors that grow out of peer group relationships are powerful. It is generally accepted that the influence of peers exceeds that of school, religion, or the awareness of other cultures during this developmental stage. |
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Term
| Which scenario is an example of the laissez-faire approach to value transmission? |
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Definition
Allowing a child to decide not to have an intravenous line inserted
A laissez-faire approach to value transmission is one that allows others, especially children, to make decisions without guidance, resulting in a decision that may not be a sound one. Teaching a child about right and wrong behavior is a more active learning strategy, and reflects the moralizing approach to value transmission. Modeling or role modeling is leading (and transmitting values) by example—in this case, not smoking electronic cigarettes to show the adolescents good behavior. Telling the child about the injection feeling like a pinch is not an approach to value transmission. |
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Term
| A client rings the call bell to request pain medication. On performing the pain assessment, the nurse informs the client that the nurse will return with the pain medication. After a few moments, the nurse returns with the pain medication. The nurse's returning with the pain medication is an example of which principle of bioethics? |
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Definition
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Term
| What are standards for decision-making that endure for a significant time in one's life? |
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Definition
Values
Values are standards for decision-making that endure for a significant time in one's life. Beliefs are more likely to be changeable and are not necessarily a long-term foundation for decision-making. Ethics is a systematic study of principles of right and wrong conduct, virtue and vice, and good and evil as they relate to conduct and human flourishing. A role is a set of responsibilities one takes on in relationship to others. |
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Term
| Nurses who value client advocacy follow what guideline? |
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Definition
They give priority to the good of the individual client rather than to the good of society in general.
Advocacy is the protection and support of another’s rights. If the nurse values client advocacy, the nurse would give priority to the good of the individual client rather than to the good of society in general. The nurse would not be demonstrating advocacy if the nurse values the loyalty to an employing institution or to a colleague over the commitment to the client. The nurse demonstrating client advocacy would not choose the claims of the client’s well-being over the claims of the client’s autonomy. The nurse would not make decisions for clients who are uninformed concerning the client’s rights and opportunities. |
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Term
| A client diagnosed with cancer has met with the oncologist and is now weighing whether to undergo chemotherapy or radiation for treatment. This client is demonstrating which ethical principle in making this decision? |
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Definition
Autonomy
Autonomy entails the ability to make a choice free from external constraints. Beneficence is the duty to do good and the active promotion of benevolent acts. Confidentiality relates to the concept of privacy. Justice states that like cases should be treated alike. |
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Term
| A nurse is of the Catholic faith and votes pro-life. This nurse is considered to have: |
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Definition
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Term
| What is the term for the beliefs held by the individual about what matters? |
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Definition
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Term
| A client tells the nurse that the client does not want to have a painful procedure. By respecting and supporting the client's right to make decisions, the nurse is demonstrating: |
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Definition
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Term
| A nurse reports to the charge nurse that a client medication due at 9 am was omitted. Which principle is the nurse demonstrating? |
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Definition
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Term
| Which is a characteristic of the care-based approach to bioethics? |
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Definition
The promotion of the dignity and respect of clients as people
The care-based approach to bioethics focuses on the specific situations of individual clients, and characteristics of this approach include promoting the dignity and respect of clients as people. The need to emphasize the relevance of clinical experience and the need for an orientation toward service are part of the criticisms of bioethics. The deontologic theory of ethics says that an action is right or wrong independent of its consequences. |
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Term
| A nurse arrives on the medical unit wearing large, dangling earrings. This is an example of which type of conduct? |
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Definition
Unprofessional
Nurses need to present and maintain a professional demeanor and image. Large dangling earrings are not appropriate or safe. Unethical conduct is conduct that is not morally correct, such as dishonesty. Incompetent conduct is conduct in which the nurse lacks the ability to perform satisfactorily. Illegal conduct is conduct forbidden by law. |
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Term
| A nurse uses the utilitarian action guiding theory when deciding how to handle the following ethical conflict: A 13-year-old client with anorexia refuses to eat food despite slowly starving to death. The parents insist that the nurse use a feeding tube to feed the client. Which statement is an example of this theory in practice? |
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Definition
The nurse forces food via an eating tube because the end result is good in that it will save the client’s life.
Ethical theories or frameworks are systems of thought that attempt to explain how we ought to live and why. The utilitarian action guiding theory examines the rightness or wrongness of an action depending on the consequences of the action. The example of this theory in practice would be the nurse force-feeding a client via an eating tube when the end result is beneficial—it will save the client’s life. The other three options are not examples of the utilitarian action guiding theory. Another action guiding theory would be the deontologic theory (an action is found to be right or wrong based on a rule, independent of its consequences). |
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Term
| A nurse is providing care to an older adult client who was just diagnosed with cancer. The client together with the immediate family discuss their preferences with the health care providers involved. The health care providers offer their clinical recommendations about possible treatments. Ultimately, the group arrives at a decision. The nurse interprets this decision-making process as reflecting which type? |
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Definition
|
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Term
| Which theory of ethics prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing? |
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Definition
Care-based ethics
Central to the care-based approach to ethics is the nurse's relationships with clients and the nurse's "being," or character and identity. Deontology is the study of the nature of duty and obligation. Utilitarianism is the doctrine that actions are right if they are useful or for the benefit of a majority. Principle-based ethics prioritizes goals and principles that exist beyond the particularities of the nurse-client relationship. |
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Term
| Which example best describes feminist ethics? |
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Definition
An approach critiquing existing patterns of oppression and domination in society
Feminist ethics offer an approach critiquing existing patterns of oppression and domination in society, especially as they affect women and the poor. The principle-based approach to ethics combines elements of utilitarian and deontologic theories and offers specific action guidelines for practice. The care-based approach directs attention to the specific situation of individual clients viewed within the context of their life narratives. The formal study of ethical issues that arise in the practice of nursing describes nursing ethics. |
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Term
| Which statement by the nurse is an example of deception? |
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Definition
"This injection of procaine will feel like a little pinch."
Telling a client that an injection of procaine will feel like a little pinch is not being truthful, and is defined as a deception. Telling a client that pain medicine will be administered when it is time is being truthful. Telling a client to get out of bed also supports a nursing intervention. Teaching a client how to give an injection is important for the client to take care of himself or herself. |
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Term
| A nurse is caring for an older adult who has cancer and is experiencing complications requiring a revision of the plan of care. The nurse sits down with the client and the family and discusses their preferences while sharing the nurse's own judgments based on the nurse's expertise. Which type of healthcare decision making does this represent? |
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Definition
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Term
| A nurse volunteers to serve on the hospital ethics committee. Which action should the nurse expect to take as a member of the ethics committee? |
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Definition
| Assist in decision making based on the client's best interests. |
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Term
| Which ethical principle is related to the idea of self-determination? |
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Definition
Autonomy
Autonomy refers to self-rule, or self-determination; it respects the rights of clients or their surrogates to make healthcare decisions. Beneficence is the duty to do good and the active promotion of benevolent acts. Confidentiality is related to the concept of privacy. Nonmaleficence is the duty not to inflict harm, as well as to prevent and remove harm. |
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Term
| Which traits are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply. |
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Definition
Compassion
Trustworthiness
Humility
Trustworthiness, humility, and compassion are all examples of professional virtues, as well as cultivated dispositions of character and conduct, that motivate and enable us to be good human beings. Deception and conflict are negative traits that do not exemplify professional virtues. |
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Term
| Which word is best described as protection and support of another’s rights? |
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Definition
Paternalism
Making a decision for a client who is confused to prevent an injury is an example of paternalism. Deception occurs when the true nature or reason is concealed and the client is deprived of basic human rights. Confidentiality requires a health care provider to keep a client’s personal health information private unless consent to release the information is provided by the client. Conflict is a disagreement or argument and does not represent the example in this question. |
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Term
| A nurse is caring for a client with terminal cancer. The family would like the client to continue aggressive treatment but the client has told the nurse that he would prefer comfort care. The nurse speaks to the family about the client's wishes, condition, and terminal state. This action is most likely derived from which nursing obligation? |
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Definition
Ethical principles
Ethics is a systematic study of principles of right and wrong conduct, virtue and vice, and good and evil as they relate to conduct and human flourishing. In this case, the nurse is practicing the ethical principle of autonomy, which is the client's right to self-determination related to choices about care. The nurse's action is not primarily motivated by legal responsibility, nursing education principles, or advanced practice licensure guidelines. |
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Term
| A nurse volunteers to serve on the hospital ethics committee. Which action should the nurse expect to take as a member of the ethics committee? |
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Definition
| Assist in decision making based on the client's best interests. |
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Term
| Nurses who value client advocacy follow what guideline? |
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Definition
| They give priority to the good of the individual client rather than to the good of society in general. |
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Term
A famous actor with bipolar disorder has been admitted in the mental health unit for treatment. A well known news outlet has offered the nurse several thousand dollars to provide information or a picture of the client. The nurse knows that it is their professional duty and legal responsibility to uphold privacy and confidentiality.
For each of the behaviors exhibited by the nurse, click to specify whether the behavior upholds the principle of privacy or confidentiality. |
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Definition
sharing client information only to the caregivers directly assigned to client care
Confidentiality ^
keeping the door closed while conducting physical assessment
Privacy ^
obtaining the client's permission before allowing a student nurse to assist with care
Privacy ^
logging off the electronic health record after documenting assessment information
Confidentiality ^
asking the client to sign a medical release form before providing information to the health insurance company
Confidentiality ^ |
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Term
| A nurse is providing care for a client with cancer. The client's spouse requests that the client not be told that the client is terminal. The nurse complies with this request. The nurse's action is a breach of which ethical principle? |
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Definition
fidelity
The principle of fidelity involves the nurse being faithful to the client, who has the right to the truth. By not telling the client, the nurse is not being faithful to the client. Justice is acting fairly. In this scenario, the nurse do not need to recognize any bias or discrimination in the distribution of care. Beneficence is the act of doing of good. The nurse is not doing good by withholding the information. Nonmaleficence means not harming or inflicting the least harm possible to reach a beneficial outcome. The nurse is inflicting harm by not being faithful to the client. |
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Term
| What is the term for the beliefs held by the individual about what matters? |
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Definition
Values
Values are ideals and beliefs held by an individual or group about what matters; values act as a standard to guide one’s behavior. Ethics are moral principles and values that guide the behavior of honorable people. A moral is a standard for right and wrong. Bioethics is related to ethical questions surrounding life and death, as well as questions and concerns regarding quality of life as it relates to advanced technology. |
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Term
| A client diagnosed with cancer has met with the oncologist and is now weighing whether to undergo chemotherapy or radiation for treatment. This client is demonstrating which ethical principle in making this decision? |
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Definition
Autonomy
Autonomy entails the ability to make a choice free from external constraints. Beneficence is the duty to do good and the active promotion of benevolent acts. Confidentiality relates to the concept of privacy. Justice states that like cases should be treated alike. |
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Term
| Which ethical principle refers to the obligation to do good? |
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Definition
Beneficence
Beneficence is the duty to do good and the active promotion of benevolent acts. Fidelity refers to the duty to be faithful to one's commitments. Veracity is the obligation to tell the truth. Nonmaleficence is the duty not to inflict, as well as to prevent and remove, harm; however, there will be times when the action may cause "harm" to promote the "good" such as chemotherapy being used to treat and eliminate cancer, but it causes various adverse effects while trying to reach the ultimate goal.. |
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Term
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Definition
knowing the correct action but being unable to perform it due to constraints.
Knowing the correct action but being unable to perform it due to constraints is the definition of moral or ethical distress. Being aware of knowing what is right and wrong is the first step of having an ethical conscience. Supporting a client during a hospitalization is an ethical principle of doing what is right (beneficence) and the focus of client-centered care. An ethical dilemma is a situation in which a person has difficulty deciding which of two or more conflicting ethical principles to follow. |
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Term
| Which nursing actions best describe the use of the professional value of human dignity? Select all that apply. |
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Definition
The nurse includes the client in developing the plan of care.
A nurse provides privacy for an older adult client.
A nurse plans individualized nursing care for clients.
A nurse refuses to discuss a client with a curious friend. |
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Term
| Which is a characteristic of the care-based approach to bioethics? |
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Definition
The promotion of the dignity and respect of clients as people
The care-based approach to bioethics focuses on the specific situations of individual clients, and characteristics of this approach include promoting the dignity and respect of clients as people. The need to emphasize the relevance of clinical experience and the need for an orientation toward service are part of the criticisms of bioethics. The deontologic theory of ethics says that an action is right or wrong independent of its consequences. |
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Term
| Which theory of ethics prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing? |
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Definition
Care-based ethics
Central to the care-based approach to ethics is the nurse's relationships with clients and the nurse's "being," or character and identity. Deontology is the study of the nature of duty and obligation. Utilitarianism is the doctrine that actions are right if they are useful or for the benefit of a majority. Principle-based ethics prioritizes goals and principles that exist beyond the particularities of the nurse-client relationship. |
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Term
| A female client is brought to the emergency room with matted hair, bruising, and malnutrition. The nurse suspects physical abuse and neglect. The nurse states, “This happens to many women.” Which type of ethical approach is the nurse exhibiting? |
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Definition
Feminist
A feminist approach is one in which the focus is on specific problems and concerns faced by women. The statement that "this happens to many women" is an example of a feminist approach. Paternalism is action limiting a person's or group's liberty or autonomy that is intended to promote their own good (e.g., if the nurse stated that "I must make all decisions about this client's care for her, as she's not in any shape to do so herself"). Values clarification is a self-assessment process that enables a person to discover the content and strength of the person's own system of values. An example of this would be if the nurse stated, "I feel bad for the client, as no one deserves this." Moralizing is to comment on issues of right and wrong, typically with an unfounded air of superiority. An example of this would be if the nurse stated, "If she was a good girl, this would have never happened to her." |
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Term
| A client is brought to the emergency department by an adult child, who states, "I am unable to care for my parent anymore. Although I would like to, financially and physically I cannot do it anymore." What ethical problem is the adult child experiencing? |
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Definition
moral distress
Moral distress is when someone wants to do the right thing but is not able. The adult child brings the parent to the emergency department to maintain the parent's safety, although the child needs to take care of the parent. Dilemma is a situation in which a difficult choice has to be made between two or more alternatives, especially equally undesirable ones. The client is not experiencing a dilemma. Uncertainty means a feeling of not knowing what will happen. The adult child is certain that he or she cannot care for the parent. Dissatisfaction implies a sense of dislike for, or unhappiness in, one's surroundings. Although the adult child is unhappy, this is not the primary ethical problem. |
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Term
| Nurses who value client advocacy follow what guideline? |
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Definition
They give priority to the good of the individual client rather than to the good of society in general.
Advocacy is the protection and support of another’s rights. If the nurse values client advocacy, the nurse would give priority to the good of the individual client rather than to the good of society in general. The nurse would not be demonstrating advocacy if the nurse values the loyalty to an employing institution or to a colleague over the commitment to the client. The nurse demonstrating client advocacy would not choose the claims of the client’s well-being over the claims of the client’s autonomy. The nurse would not make decisions for clients who are uninformed concerning the client’s rights and opportunities. |
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Term
| The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy? |
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Definition
Limiting visitors due to the client reporting pain
Advocating for clients is a nursing responsibility and is performed with the best interest and welfare of the client in providing safe, competent, and comforting care. Limiting visitors is an example of advocacy. The nurse recognizes that the client is in pain; therefore, limiting the visitors allows for the nurse to advocate for additional measures to allow the client to rest and recover. Administering pain medication and turning and the client every 4 hours are important and necessary interventions for a postoperative client, but this is not advocacy. Changing the channel on the television while providing care also does not promote advocacy. |
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Term
| A client has been diagnosed with a debilitating neuromuscular disease that has left the client tired, confused, and in pain. Which action(s) will the nurse choose to advocate for this client in planning future care? Select all that apply. |
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Definition
-Provide education about treatments.
-Facilitate involvement of people essential to the decision.
-Explain laboratory and radiology findings. |
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Term
| A nurse is caring for a hospitalized client. Which nursing actions demonstrate a caring and compassionate attitude? Select all that apply. |
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Definition
notifying the client before leaving for lunch
offering snacks and beverages to visiting family
explaining all nursing procedures clearly
listening to the client tell stories about past experiences |
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Term
| Which is the best definition of ethics? |
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Definition
The formal, systematic study of moral beliefs
Ethics is a formal, systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil as they relate to human conduct and human flourishing. “Morals” usually refers to personal or communal standards of right and wrong. |
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Term
| Which action most clearly demonstrates a nurse's commitment to social justice? |
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Definition
Lobbying for an expansion of healthcare resources and benefits to those in poverty
Social justice is a professional value that encompasses efforts to promote universal access to health care, such as the expansion of publicly funded programs like Medicare. Culturally competent care is a reflection of human dignity. Answering clients' questions and documenting care accurately are expressions of the value of integrity. |
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